Current Cancer Drug Targets

Ruiwen Zhang 
Texas Tech University Health Sciences Center
1300 Coulter Drive
Amarillo, TX 79106
USA

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The Prognosis of Patients with Liver Metastases from Colorectal Cancer still Depends on Anatomical Presentation more than on Treatments

Author(s): Paolo G. Gobbi, Sandro Rossi, Mario Comelli, Valentina Ravetta, Laura L. Rosa, Silvia Brugnatelli, Franco Corbella, Sara Delfanti, Islam Abumalouh, Paolo Dionigi.

Graphical Abstract:


Abstract:

Background: The best management of liver metastases from colorectal cancer is still debated and little is known about the true impact of treatments on survival.

Materials and Methods: The study involved 122 patients (77 males), aged 64.0 ± 11.0 years (range: 27.8–86.1) at diagnosis of liver metastatization (synchronous in 59). All underwent chemotherapy and at least one procedure of radiofrequency ablation; 53 also had partial hepatic resections. Demographics, tumor characteristics and survival outcomes from liver metastatization were analyzed with univariate and multivariate techniques. This analysis was performed also taking into account relative survival as the best estimate of specific survival.

Results: The analysis with observed survival selected the categorized number of involved lymph nodes in the colorectal specimens as the only statistically significant predictor, while the analysis with relative survival also showed site of the primary tumor (above the sigmoid colon or otherwise) and number of liver metastases as significant factors. The standardized mortality ratio was 9.673 (95% CI: 7.668–11.663) and a total of 201.85 years of life were lost in comparison with the survival of the reference population.

Conclusions: The computation of relative survival – better than observed survival – selected a more adequate number of predictors, making investigation of even limited series of patients with confounding factors reliable. The finding that prognosis was mainly dependent on the anatomical presentation of the primary tumor and of liver metastases – instead of treatments – could explain the still contrasting opinions on the role of the available therapies in this field.

Keywords: Colorectal carcinoma, liver metastases, multivariate analysis, prognostic factors, relative survival, specific survival.

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Article Details

VOLUME: 15
ISSUE: 6
Year: 2015
Page: [511 - 518]
Pages: 8
DOI: 10.2174/1568009615666150508094824
Price: $58